Intensive Care and Emergency Medicine : Progress Over the Past 25 Years

Over the last quarter of a century, intensive care medicine has developed into an established hospital specialty with its own unique identity and characteristics. Significant advances have occurred, mostly in a succession of small steps rather than any dramatic leap, with many being linked to advances in health care across other disciplines. In addition, many changes have resulted from the scientific identification of the detrimental effects of certain traditional practices once thought to be therapeutic. Here, in an attempt to learn from the past and offer guidance for future progress, we detail some of the key changes in various aspects of intensive care medicine including respiratory, cardiovascular, metabolic, and nutritional care, as well as sepsis, polytrauma, organization, and management.Learning objectivesDistinguish the significant advances in intensive care medicine that have occurred, largely as a result of a succession of small steps in many aspects of intensive care medicine 2. Evaluate the many advances that have occurred as a result of scientific identification of the detrimental effects of certain traditional practices once thought to be therapeutic